Glycemic variability and frequent hypoglycemic episodes are some of the most difficult issues in the management of type 1 diabetes (T1D). We performed a retrospective analysis that included 27 subjects from 13 to 54 years of age diagnosed with T1D, using a multiple daily insulin injection treatment and under continuous glucose monitoring with a Medtronic iPro2 device for six days. We divided the sample in two groups: A) those with 10% or less of the time in hypoglycemia and B) those with more than 10% of time in hypoglycemia. Their median age was 27.8 years, 48.1% were males, with a median duration of disease of 13 years and a median of A1C of 7.8%. The time in range (blood glucose from 70 to 180 mg/dL) was 44% in both groups. The group of patients with more than 10% of the time in hypoglycemia had a lower A1C (7.5 vs. 7.9%, p=0.034) along with a higher number of hypoglycemic episodes in the night time (0 vs. 3, p<0.001), as well as increased episodes during the entire day (2 vs. 12.0 p<0.001). Patients who spent more time in range also showed lower levels of A1C, although all of them had more than 10% of time in hypoglycemia.
In conclusion, adequate A1C levels do not assure adequate control of disease given the increased time in hypoglycemia observed in this set of patients.
Figure 1. Correlation Between Mean A1c and Time in Range in Patients with T1D A1C, Glycated Hemoglobin; SD, Standard Deviation.
J. Calvo: None.
